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Pharmacopsychiatry Mar 2024Online self-diagnosis of psychiatric disorders by the general public is increasing. The reasons for the increase include the expansion of Internet technologies and the... (Review)
Review
Online self-diagnosis of psychiatric disorders by the general public is increasing. The reasons for the increase include the expansion of Internet technologies and the use of social media, the rapid growth of direct-to-consumer e-commerce in healthcare, and the increased emphasis on patient involvement in decision making. The publicity given to artificial intelligence (AI) has also contributed to the increased use of online screening tools by the general public. This paper aims to review factors contributing to the expansion of online self-diagnosis by the general public, and discuss both the risks and benefits of online self-diagnosis of psychiatric disorders. A narrative review was performed with examples obtained from the scientific literature and commercial articles written for the general public. Online self-diagnosis of psychiatric disorders is growing rapidly. Some people with a positive result on a screening tool will seek professional help. However, there are many potential risks for patients who self-diagnose, including an incorrect or dangerous diagnosis, increased patient anxiety about the diagnosis, obtaining unfiltered advice on social media, using the self-diagnosis to self-treat, including online purchase of medications without a prescription, and technical issues including the loss of privacy. Physicians need to be aware of the increase in self-diagnosis by the general public and the potential risks, both medical and technical. Psychiatrists must recognize that the general public is often unaware of the challenging medical and technical issues involved in the diagnosis of a mental disorder, and be ready to treat patients who have already obtained an online self-diagnosis.
Topics: Humans; Artificial Intelligence; Psychotic Disorders; Psychiatry; Anxiety Disorders
PubMed: 38471511
DOI: 10.1055/a-2268-5441 -
The Journal of Neuropsychiatry and... 2024In the early 20th century, neurology training included more experience in psychiatry, and psychiatry training included more training in neurology than what is currently...
In the early 20th century, neurology training included more experience in psychiatry, and psychiatry training included more training in neurology than what is currently required. After World War I, the increased need for differential diagnosis of what might now be called functional neurological disorders resulted in the military encouraging combined residency training in neurology and psychiatry and the promulgation of the term "neuropsychiatry" for this specialty. Thirty-six percent of physicians certified by the American Board of Psychiatry and Neurology in its first decade (1935-1945) held certification in both neurology and psychiatry. However, the term neuropsychiatry gradually became used interchangeably with general psychiatry-to distinguish it from psychoanalysis-and lost its specificity. It is widely held that the popularity of psychoanalysis resulted in psychiatrists perceiving less need for neurological knowledge, and inclusion of neurology content in psychiatry training decreased. Dual residency training programs in neurology and psychiatry began to increase in popularity again in the 1980s as advances in neuroscience, neuroimaging, and pharmacology, paired with the growth of behavioral neurology, laid the foundation for meaningful practice of neuropsychiatry. The author surveyed 207 physicians who graduated from both a neurology and psychiatry residency and 18 current trainees in combined neuropsychiatry residency programs to collect information on their current practice, academic activity, and opinions about their training. The response rate was 64%. Respondents' attitudes toward the value of their dual neurology and psychiatry training were overwhelmingly positive. Reasons for the lack of growth of combined residency programs in neurology and psychiatry are examined.
Topics: Humans; United States; Internship and Residency; Psychiatry; Neurology; Neurosciences; Neuropsychiatry
PubMed: 37727060
DOI: 10.1176/appi.neuropsych.21110271 -
The Journal of Nervous and Mental... Jan 2024The research relevance is predefined by the fact that, in modern psychology and psychiatry, the concepts of psychopathy and sociopathy are combined and interchanged....
The research relevance is predefined by the fact that, in modern psychology and psychiatry, the concepts of psychopathy and sociopathy are combined and interchanged. These are two concepts that describe different etiologies of the same mental health condition. The research aims to describe in detail the main manifestations and characteristics of personality disorders (psychopathy and sociopathy) in psychiatry and psychology. The research analyzes the main features and manifestations of sociopathy and psychopathy. It examines the work of psychologists, psychiatrists, neurologists, and neurosurgeons in helping sociopaths and psychopaths. The study also explores the challenges of treating antisocial personality disorders and identifies internal and external factors that influence the development of these conditions. In addition, the article emphasizes the behavioral differences between sociopaths and psychopaths, proposes various methods for integrated therapy, diagnoses the main aspects of these disorders, and highlights the importance of psychiatric care and psychotherapeutic interventions. The research is of theoretical and practical value for psychologists, psychoanalysts, and physicians who can help people with these pathologies of personal development.
Topics: Humans; Antisocial Personality Disorder; Psychiatry; Psychotherapy
PubMed: 38166182
DOI: 10.1097/NMD.0000000000001728 -
Journal of Clinical Psychopharmacology
Topics: Humans; Pregnancy; Female; Psychiatry; Placenta
PubMed: 38011028
DOI: 10.1097/JCP.0000000000001779 -
The Journal of Physician Assistant... Sep 2023The aim of this pilot study was to assess whether supplemental psychiatry training in the didactic year increases the scores on the Physician Assistant Education...
INTRODUCTION
The aim of this pilot study was to assess whether supplemental psychiatry training in the didactic year increases the scores on the Physician Assistant Education Association (PAEA) Psychiatry and Behavioral Health End of Rotation examination and psychiatry preceptor evaluation.
METHODS
Data were obtained from the physician assistant (PA) students on PAEA Psychiatry and Behavioral Health End of Rotation examination and psychiatry preceptor evaluation for a single institution. Then, a comparison was performed for PA students who did not participate in supplemental psychiatry/behavioral health training (Cohort 1/historical control group; n = 62) and PA students who participated in supplemental psychiatric and behavioral health training (Cohort 2/experimental group; n = 63) to determine the effects of the groups.
RESULTS
An independent t test demonstrated that the experimental group performed significantly better than the control group on both the Psychiatry and Behavioral Health PAEA End of Rotation examination and preceptor evaluation {control group (M = 83.4) and experimental group (M = 86.3; t [117] = 2.8; P < .05)} and the preceptor evaluation {control group (M = 90) and experimental group (M = 92.6; t [112] = 2.1; P < .05)}. In addition, both analyses demonstrated a moderate effect size (End of Rotation examination, d = 0.51; preceptor, d = 0.62). A multiple regression analysis was used to control for age, sex, grade point average (GPA), and training intervention. Age, sex, and GPA were found not to affect the results. However, treatment intervention was statistically significant for both the End of Rotation examination and preceptor evaluation scores.
DISCUSSION
Supplemental training in behavioral health and psychiatry, which included a standardized patient encounter and an interactive session dedicated to psychiatry interviewing techniques, resulted in students performing better on the Psychiatry and Behavioral Health PAEA End of Rotation examination and preceptor evaluation.
Topics: Humans; Pilot Projects; Physician Assistants; Educational Measurement; Educational Status; Psychiatry
PubMed: 37467191
DOI: 10.1097/JPA.0000000000000512 -
Behavioral Sciences & the Law 2024As neuroscience technologies develop, ethical and legal questions arise regarding their use and societal impact. Neuroethics and neurolaw are growing interdisciplinary... (Review)
Review
As neuroscience technologies develop, ethical and legal questions arise regarding their use and societal impact. Neuroethics and neurolaw are growing interdisciplinary fields that address these questions. This review article presents the research agenda of both areas, examines the use and admissibility of neuroscience in expert testimony and legal settings, and discusses ethical issues related to forensic neuropsychiatrists claiming expertise in neuroscience, formulating medical opinions based on neuroscience, and considering its relevance to criminal responsibility. Forensic neuropsychiatrists should be aware of emerging neuroscientific evidence, its utility and limits in rendering diagnoses and explaining behavior, and, before seeking such evidence for legal purposes, its availability and admissibility. When testifying in matters involving neuroscientific evidence, ensuring truthfulness and balance, having sufficient and validated knowledge (including openness with confirming and disconfirming evidence), understanding standards of practice, and drawing relevant and appropriate conclusions remain important.
Topics: Humans; Forensic Psychiatry; Neuropsychiatry; Expert Testimony; Neurosciences
PubMed: 37983666
DOI: 10.1002/bsl.2638 -
Journal of Medical Ethics Aug 2023Researchers are studying how artificial intelligence (AI) can be used to better detect, prognosticate and subgroup diseases. The idea that AI might advance medicine's...
Researchers are studying how artificial intelligence (AI) can be used to better detect, prognosticate and subgroup diseases. The idea that AI might advance medicine's understanding of biological categories of psychiatric disorders, as well as provide better treatments, is appealing given the historical challenges with prediction, diagnosis and treatment in psychiatry. Given the power of AI to analyse vast amounts of information, some clinicians may feel obligated to align their clinical judgements with the outputs of the AI system. However, a potential epistemic privileging of AI in clinical judgements may lead to unintended consequences that could negatively affect patient treatment, well-being and rights. The implications are also relevant to precision medicine, digital twin technologies and predictive analytics generally. We propose that a commitment to epistemic humility can help promote judicious clinical decision-making at the interface of big data and AI in psychiatry.
Topics: Humans; Artificial Intelligence; Psychiatry; Mental Disorders; Precision Medicine; Clinical Decision-Making
PubMed: 36581457
DOI: 10.1136/jme-2022-108447 -
The American Journal of Psychiatry Nov 2023
Topics: Humans; Psychiatry; Societies, Medical
PubMed: 37908091
DOI: 10.1176/appi.ajp.23180011 -
Current Opinion in Psychiatry Sep 2023This review will discuss the current development of ethical dilemmas in psychiatry in the care of migrants and refugees. The world is in times of increasing conflicts... (Review)
Review
PURPOSE OF REVIEW
This review will discuss the current development of ethical dilemmas in psychiatry in the care of migrants and refugees. The world is in times of increasing conflicts and disasters, which are leading to increased migration and flight. In dealing with patients, psychiatrists have their own codes of ethics. The purpose of developing codes of ethics is to serve educational and regulatory functions and to provide explicit and visible standards for the professional conduct of psychiatrists.
RECENT FINDINGS
The codes of ethics are more recognised and required as standards in the form of guiding ethical principles on duties and rights as well as explicit rules. However, in the case of migrants and refugees, ethical principles are suspended in many places, exposing patients to different barriers.
SUMMARY
Many National Psychiatric Associations have adopted the World Psychiatric Association or European Psychiatric Association Code of Ethics for Psychiatry. However, migrants and refugees still do not have the same rights and opportunities to access mental healthcare as well as preventive measures and thus equal treatment due to various barriers. Not only is equal treatment suspended in comparison to native patients, but also access to care between migrants and refugees from different regions of origin for various reasons. This invalidates the ethical principles.
Topics: Humans; Transients and Migrants; Refugees; Psychiatry; Health Services Accessibility; Mental Health Services
PubMed: 37439596
DOI: 10.1097/YCO.0000000000000886 -
[Gender-specific aspects in neurology and psychiatry with a focus on family planning and pregnancy].Der Nervenarzt Apr 2024
Topics: Female; Pregnancy; Humans; Family Planning Services; Neurology; Psychiatry
PubMed: 38607400
DOI: 10.1007/s00115-024-01643-3